Calcium Scores Best Predictor of Heart Attack Risk

CAC may benefit adults who could be at an immediate risk of a heart attack within the next 10 years, according to American Heart Association guidelines. Those risk factors include obesity, prediabetes or a family history of heart disease.

Future guidelines for primary heart disease prevention should even include CAC for high risk patients with normal cholesterol levels, said the association.

"We think that it is time to move past traditional risk factors and blood tests and toward incorporation of direct measures of subclinical atherosclerosis in risk prediction," Dr. Michael Blaha, cardiologist at Johns Hopkins University and author of the study, said in a statement.

"This makes sense, because CAC uses modern technology to directly measure the disease we propose to treat with statins," said Blaha.

The Lancet study was actually a substudy of a previous trial by the researchers, who looked at C-reactive protein levels in asymptomatic patients.

In an accompanying editorial, German doctors said the case made for testing CAC over C-reactive protein was so strong that they now use CAC for treatment in their clinic.

The University of Miami hospital, where Leahy works, offers CAC scans to all of its employees over the age of 50.
Still, some experts said that even if a calcium score could help some patients get on such preventive therapies as statins, it's premature to suggest that all would benefit from the findings of the test.

"For a call that everyone should have one, I think we need a randomized trial to show that it is beneficial to screen and then treat differently before it could be recommended for the public," said Dr. Christopher Cannon, a cardiologist at Boston's Brigham and Women's Hospital.